I have been an Emergency Room Doctor for the last 15+ years and trip doctor on several wilderness trips and de facto doctor on many other wilderness trips around the world. As an Emergency Room doctor at home, you have all of the modern technologies such as X-rays, laboratory tests and specialty consultants available. It would be great to take these back-up systems with us to Mt. Everest, but this is not possible, as a CAT scan would hardly fit on the back of a yak.

As I learned as team doctor on the 1999 Mallory & Irvine Expedition, the North side of Mt. Everest, presents its own special challenges with respect to medical support. Base camp is at the end of the Central Rongbuk Glacier about 17,000 ft., while Advanced Base camp (ABC), where the real climbing begins, is 12-15 miles up the East Rongbuk Glacier at an elevation of 21,500 ft. I obviously cannot be at both places at once, but generally plan to be at ABC, when the climbers are up high searching for artifacts or during the summit bids.

For the Expedition, we have prepared two large and complete Medical kits, one for Base camp and the other for ABC. Each kit was prepared to handle any type of life-threatening or minor emergencies that could occur on the mountain. Equipment in the kits will allow us to breath for injured climbers, chest tubes for collapsed lungs, IV fluids (these must be thawed out at ABC) for dehydration or serious infections or severe frostbite, a complete chest of IV & oral medications for pain control, infections, vomiting, seizures, sedation etc. Complete suture and surgical kits as needed are also included. Medical oxygen and Gamow bags (portable pressure chambers for high altitude problems) are at each of the camps.

Contingency plans for evacuation to a hospital in Kathmandu have been developed. At home, I went through my mind how we would handle certain emergencies and what would be needed. I am in radio contact with all the camps and climbers no matter which camps we might be located. Our climbers are long time guides and very experienced in medical problems at high altitude and therefore my job becomes one of a consultant.

In future dispatches, I will cover some of the medical problems we have experienced and some of the special medical problems of high altitude.